CIO Designation

CIO Designation Application Form

DESIGNATION PROCESS

This application must be completed and submitted to the CIO Association of Canada, Designation Committee for review. This review will involve verification of all submitted information and response regarding CIO Designation obtainment to the applicant will be within 30 days.

APPLICANT INFORMATION

Program Start Date
Name
Name
First Name
Last Name
Primary Telephone
Secondary Telephone
Primary Email
Secondary Email

ELIGIBILITY CRITERIA

Applicants must meet all of the following criteria on an ongoing basis, as applicable, to officially obtain, use and reference themselves as a “Designated CIO by the CIO Association of Canada”
  1. Must have successfully completed the CIO Executive Leadership Program for IT Leaders offered by the CIO Association of Canada in partnership with the Rotman School of Management at the University of Toronto.
  2. Must be a member in good standing of the CIO Association of Canada
  3. Must have worked a minimum of 3 years in IT leadership role and still currently be in a leadership role.
Signature (Draw or Type)

CURRENT EMPLOYER INFORMATION

Employment
Employment
Employer Name
Job Title
Employer Address
City
Province
Postal Code
Industry sector
Type of organization
To whom do you report?
What is their title?
Do you have any direct reports?
If yes, how many?
Please describe your current role and the specifics of your 3 years of IT leadership including any past employers and roles

REFERENCES

Please provide the names and contact information of two references that can attest to your 3 years of leadership experience

Reference #1

Name of Reference
Name of Reference
First Name of Reference
Last Name of Reference
Organization
Title
Relationship to applicant
Telephone
Email

Reference #2

Name of Reference
Name of Reference
First Name of Reference
Last Name of Reference
Organization
Title
Relationship to applicant
Telephone
Email

FEES

An active CIOCAN membership is a requirement for maintaining CIO Designation by the CIO Association of Canada.
A full membership is required for the first year $750.
On subsequent years if you just wish to maintain your Designation and not participate in the benefits of a full membership, the annual fee is $300.
Payment is due upon completion of your application review.

DECLARATION

I hereby certify that all statements on the application and in any material filed in support hereof are true, correct and complete, and all material information has been disclosed. I understand that if the CIO Association of Canada finds to the contrary, my application for CIO Designation may be rejected. I pledge to conduct myself in a manner of integrity, honesty and respect for individuals in the CIO Association of Canada community. If I am found to act in a manner contrary to the aforementioned values, I understand that I may lose my Designation as a CIO.
Signature (Draw or Type)
Date

Maximum file size: 52.43MB

Upload Current CV (accepted file types: .doc and .pdf)

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